Robotic-Guided Percutaneous Pedicle Screw Implantation Using the CIRQ Robotic Alignment Module.

CIRQ Robotic Alignment Module is a second-generation robotic arm from Brainlab (Munich, Germany).1 Previous studies have described use of the first generation with the so-called passive assistance.2-5 In this Video Article, we demonstrate robotic-guided K-wire implantation using the second generation with active assistance, followed by navigated pedicle screw implantation in lumbar spine in a patient with instability due to infection.6 Workflow includes preoperative screw planning, intraoperative computed tomography with automatic registration, fusion with preoperative imaging and review of the preplanned screw trajectories, robotic-assisted insertion of K-wires and navigated insertion of pedicle screws, followed by control intraoperative computed tomography scan.1,7 Our operative video adds to the growing body of literature demonstrating minimally invasive robotic assisted spinal fusion techniques (Video).8.